The Division of Pathology and Laboratory Medicine is the integral bridge between clinical care and basic science at The University of Texas MD Anderson Cancer Center. It plays an essential role in the institution's mission to improve patient care and eliminate cancer and allied diseases as a significant problem in Texas, the United States and the world.

The division comprises three clinical departments and one research department. The clinical departments are CLIA certified and CAP accredited.

The division and the departments serve MD Anderson patients, Outreach and Physician Network patients and clinical staff. The faculty engages in programmatic and interdisciplinary basic, clinical and translational research.

Facilities and faculty

The division occupies more than 210,000 square feet in six adjoining buildings within the MD Anderson complex in the Texas Medical Center as well as two remote locations. It employs over 130 clinical and research doctoral faculty and over 40 clinical fellows. In the division, the supporting technical and clerical staff numbers 900. The clinical laboratory processes 11.5 million technical and 733,000 professional billables per year.

The faculty includes expertise across the entire spectrum of oncologic pathology, hematopathology and laboratory medicine. Surgical Pathology is now divided into nine subspecialty groups: breast, dermatopathology, gastrointestinal, genitourinary, head and neck, neuropathology, sarcoma/bone, thoracic/mediastinal and hematopathology.

Specimen handling and diagnosis

In anatomic pathology, approximately 87,000 specimens are submitted annually and approximately 80 autopsies are performed each year.

Over 30,000 cytology cases are processed each year including both GYN and non-GYN cases. The laboratory staff and the Cytopathologists provide superficial FNA services and support ultrasound guided FNA acquisition at numerous sites within the hospital.

Hematopathology evaluates approximately 17,000 bone marrow specimens and 3,100 lymph node specimens per/year which includes aspirate smears, clot sections, biopsies and special stains. The molecular laboratory offers more than 165,000 state-of-the-art molecular assays for cancer diagnosis and disease monitoring. Flow cytometry offers more than 180,000 tests per year for patients with hematological malignancies as immunophenotyping is an essential tool for diagnosis, classification and monitoring of leukemia and lymphoma. Cytogenetics laboratory performs approximately 48,000 tests/year which offers metaphase and interphase chromosome analysis, which aids in the diagnosis, prognosis and monitoring of hematologic disorders and solid tumors. Outside Services in Hematopathology handles the accession of all referral and consultation material submitted. These samples include blood, bone marrow, tissue, slides and blocks.

There are approximately 400-500 new acute and chronic leukemia cases per year. Approximately 400 new lymphomas are available for review annually. The section of Lymph Node Pathology is responsible for the diagnosis of tissue biopsies from patients with lymphoma as well as those with a variety of non-neoplastic conditions involving lymphoid tissues. Most of the cases represent in-house patients that include Hodgkin's and non-Hodgkin's lymphomas.

Laboratory Medicine performs diagnostic routine and esoteric testing. The testing results are used for clinical management of our patients. Highly trained and certified technologists perform the tests with state-of- the-art automated analyzers, they perform manual microscopic and analytical procedures necessary to provide accurate test results. Specialized clinical pathologists provide interpretation of test results and consult with medical staff. In addition, Transfusion Medicine and Donor Center supply all the blood and blood components necessary to support the medical and surgical management of our patients. The section of Microbiology works closely with Infection Control staff, to maintain an active infection control program that covers all the hospital areas.

Laboratory Medicine performs over 9.2 million billables annually. Services include high volume chemistry, hematology and coagulation; microbiology and virology; point of care tests; HLA for bone marrow transplant and infectious disease testing for blood products. Over 500,000 phlebotomies are performed annually. In addition the laboratories support research and development of tests, and educational development of employees. The sections also provide laboratory support to other clinical divisions for research protocols. Several members of the departmental staff also maintain their own clinical research programs supported by governmental and/or private grants.

Consultation and diagnostic services

Consultation on specimens from patients sent to MD Anderson, or second opinion cases, represent about 35% of our caseload. The review of diagnostic material obtained and evaluated elsewhere has been shown to be of significant importance both in terms of quality of care and economic benefit.